In this 1st edition of my blog, and because I am a little nervous to post one, I will be presenting an article written by Rachel Carlyle.
Think of dementia and what comes to mind? An 80 year old confined to a care home, alone and confused?
While it’s true that dementia is a disease of older people – our risk of getting it doubles every five years after we turn 65 – many of us would be shocked to learn that it actually begins in middle age. The tangles and plaques of protein that kill off brain cells in Alzheimer’s disease, the most common form of dementia, begin developing 10 to 20 years before we show the classic symptoms of memory loss and confusion.
“Really, Alzheimer’s is a disease of midlife that expresses itself in later life, but there isn’t yet a good public understanding of that idea,” says Dr Craig Ritchie of Imperial College London. Ritchie has just started a study following 40 to 59 year olds over several decades to find out exactly when the disease begins, who is most at risk and, crucially, whether it can be prevented.
Obviously, age is the biggest risk – and there’s an element of bad luck – but there’s a genetic component, too. People with the ApoE4 gene are more likely to develop dementia, as are those with two or more close family sufferers.
While we can’t do much to change that, a huge 35-year study published in December suggests that we might have an element of control. Carried out in South Wales, the study looked at more than 2,000 men aged 45 to 49 and revealed that those who managed to keep to four out of five healthy lifestyle rules slashed their odds by an incredible 60 per cent. The rules were: no smoking, keeping body weight low, taking regular exercise, eating a healthy diet and having a low alcohol intake.
The study shows how important those middle years are, says Dr Ritchie. “You see middle-aged men in Lycra cycling around parks on a Sunday morning to reduce their risk of heart disease, and we need to start thinking about dementia in these terms, too – keeping your brain healthy, not just your heart.”
There’s not enough research yet to know exactly the right lifestyle “recipe”, says Dr Clare Walton at the Alzheimer’s Society, as most of the studies are small and many have conflicting conclusions. But there is a picture beginning to emerge. Here are the
10 most vital measures you can take to minimize your risk.
- 1. Have checks for cholesterol, blood pressure, and diabetes.
Surprisingly, checks for these conditions are top of the list in preventing the condition – along with taking exercise. People with untreated diabetes, high blood pressure and cholesterol have vastly higher rates of dementia. “We’re not sure exactly why, but it’s thought to be related to blood vessel health. Inflammation of blood vessels in the brain is thought to have a strong connection to dementia,” says Dr Walton. So is taking statins, the cholesterol-lowering drugs, the answer? Research is split on this one, but the important thing is for people in their mid-forties and beyond to have regular blood pressure and cholesterol checks and get treated if necessary.
- You’d better shape up.
There’s more evidence that exercising in your forties and fifties will prevent dementia than for any other measure we might take. Scientists don’t know why exactly, but it is probably because it reduces blood pressure, controls cholesterol, helps blood vessel health and keeps weight down.
“All of these factors are linked to dementia, so we think that’s the link,” says Dr Walton. “There are other theories – for example, we know that exercise can promote the creation of new brain cells in animals, as well as a greater connection between those cells, but there’s not the evidence in humans yet.” Frequent moderate exercise is better than short bouts of intense activity. Dr Walton recommends the Government guidelines: 150 minutes a week of moderate exercise such as brisk walking or cycling.
- Eat chocolate and drink tea
This isn’t quite as exciting as it sounds, because it’s the flavonoids that appear to make the difference – and there’s more of those in dark chocolate and green tea than our favorite milk chocolate (where manufacturers often remove them because they’re bitter) or black tea. Several studies have shown that older people given a regular high-concentration cocoa drink showed big improvements in cognitive tests, and other research has shown a diet rich in flavonoids in middle age can protect cognitive function in old age. Why? It’s thought to be because flavonoids are an antioxidant – the chemicals in our bodies that mop up harmful molecules and protect our cells as we age. Other good sources of flavonoids are apples, grapes, bananas, berries, all citrus fruit, parsley and onions, but they are present in smaller quantities in most fruit and vegetables.
- Catch of the day
Oily fish such as mackerel, salmon and herring contain huge amounts of omega-3 fatty acid, which can help prevent or at least delay Alzheimer’s according to some studies. One from New York showed it could lower blood levels of the toxic protein beta-amyloid, which is one of the main hallmarks of Alzheimer’s when it’s found in the brain. Other research shows people with low levels of omega-3 score lower in cognitive tests and have a smaller brain volume. But if you hate oily fish, all is not lost. There are omega-3s – albeit in smaller quantities – in chicken, nuts, Brussels sprouts, kale and spinach. However, there is no evidence that omega-3 supplements work.
- Dive into Mediterranean food.
How often are we told to eat along Mediterranean lines for our health? That means plenty of fruit and vegetables, fish, olive oil and nuts, a little red wine and not much meat or dairy. “We don’t know which factor is most important here,” says Dr Walton, “whether it’s the fruit and veg, the omega-3s from the oily fish, the low sugar, the tannins from the red wine or the fact that you get your fat from olive oil, fish and nuts rather than dairy and red meat.” At the time of the G8 summit on dementia last December, 11 leading doctors wrote to Prime Minster David Cameron saying there was more evidence for the diet than any drug or supplement.
- Don’t feel guilty about coffee.
A couple of cups a day may protect our brains, according to several studies. This is probably down to the effect of caffeine. A four-year study in Florida of people over 65 found that those who showed early signs of dementia had 50 per cent less caffeine in their systems than those who didn’t develop symptoms. Scientists concluded that keeping your caffeine levels topped up either reduces the risk or at the very least delays dementia. Three cups a day was the critical amount.
- Drink alcohol (but only a bit)
A small amount of alcohol a week seems to cut the risk, especially red wine because of the polyphenols it contains. But too much increases the risk – probably because regularly drinking too much alcohol increases your blood pressure and makes you fat, which are risk factors for dementia. So how much is too much? One of the key studies concludes that one to six drinks a week (where one drink is half a pint of beer or a medium glass of wine) cuts your risk. Any more and the effect is lost.
- Deal with stress and depression
Stress is emerging as an important risk for dementia, especially among those with a long-term, high-stress lifestyle. It is thought to be due to the effect of the stress hormone cortisol, which causes high blood pressure and may kill off brain cells. There’s also a definite link between depression and dementia: those with long-term depression have more plaques and tangles in their brains and are more likely to develop dementia
symptoms. So does depression actually cause dementia or is it just an early symptom? We don’t know yet, but Dr Ritchie believes treating depression in midlife is very important to reduce your risk of dementia.
- Use it or lose it.
The philosophy that you should use your brain to preserve it by doing lots of puzzles, crosswords and reading has gained huge currency in the past few years. But there are two problems with it: the first is, what counts as “using” it? Some studies have shown the benefits of brain-training computer programs among the over sixties (not for younger people, though). But the evidence for crosswords or Sudoku just isn’t there. Scientists believe that frequently challenging your brain with new things is the key, so doing a similar crossword every day won’t work. What’s more effective is taking up a new hobby, learning a language or even walking an unfamiliar route. Even then, you’re not really stopping yourself from “losing” it – you’re simply delaying the onset of symptoms. Because you’ve built up cells and connections in your brain through exposing yourself to new challenges, you can afford to lose more before you notice it. That explains why those with the highest levels of education tend to get dementia later – they have a “cognitive reserve” to call on. But when symptoms do start, the dementia progresses 50 per cent faster, says Dr Walton.
- Look after teeth and gums.
It sounds unlikely, but once the bacteria responsible for poor oral health – such as porphyromonas gingivalis – get into your bloodstream, they can increase your risk of stroke, rheumatoid arthritis and possibly dementia. A small study at the University of Central Lancashire last summer showed that the dementia patients all had the bacteria in their brains, while those without dementia didn’t. Other studies have indicated that older people with bad gum disease were two to three times more likely to have memory problems than those with little or none.
Stay tuned for more blogs and wonderful article I come across. Have a great month!